Bronchial Thermoplasty for Severe Asthma
- 1 April 2012
- journal article
- review article
- Published by American Thoracic Society in American Journal of Respiratory and Critical Care Medicine
- Vol. 185 (7), 709-714
- https://doi.org/10.1164/rccm.201105-0883ci
Abstract
Bronchial thermoplasty (BT) is a novel treatment of patients with severe asthma who continue to be symptomatic despite maximal medical treatment. It aims to reduce the smooth muscle mass in the airways by delivering controlled thermal energy to the airway walls during a series of three bronchoscopies. Randomized controlled clinical trials of BT in severe asthma have not been able to show a reduction in airway hyperresponsiveness or change in FEV(1) but have suggested an improvement in quality of life, as well as a reduction in the rate of severe exacerbations, emergency department visits, and days lost from school or work. Strict inclusion and exclusion criteria of these trials resulted in the elimination of patients with severe asthma who experienced more than three exacerbations per year. Therefore, the generalizability of this treatment to the broader severe asthma population still needs to be determined. The short-term adverse events consist primarily of airway inflammation and occasionally more severe events requiring hospitalization. Long-term safety data are evolving and have shown thus far clinical and functional stability up to 5 years after BT treatment. Additional studies on BT are needed to establish accurate phenotyping of positive responders, durability of effect, and long-term safety.Keywords
This publication has 37 references indexed in Scilit:
- Bronchial ThermoplastyClinics in Chest Medicine, 2010
- A Randomized, Double-blind, Placebo-controlled Study of Tumor Necrosis Factor-α Blockade in Severe Persistent AsthmaAmerican Journal of Respiratory and Critical Care Medicine, 2009
- Mepolizumab for Prednisone-Dependent Asthma with Sputum EosinophiliaThe New England Journal of Medicine, 2009
- Daclizumab Improves Asthma Control in Patients with Moderate to Severe Persistent AsthmaAmerican Journal of Respiratory and Critical Care Medicine, 2008
- Expert Panel Report 3 (EPR-3): Guidelines for the Diagnosis and Management of Asthma–Summary Report 2007Journal of Allergy and Clinical Immunology, 2007
- Characterization of the severe asthma phenotype by the National Heart, Lung, and Blood Institute's Severe Asthma Research ProgramJournal of Allergy and Clinical Immunology, 2007
- A Prospective Feasibility Study of Bronchial Thermoplasty in the Human AirwaySocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2005
- Reduction in airway hyperresponsiveness to methacholine by the application of RF energy in dogsJournal of Applied Physiology, 2004
- Efficacy and safety of a recombinant anti‐immunoglobulin E antibody (omalizumab) in severe allergic asthmaClinical and Experimental Allergy, 2004
- Airway Smooth MuscleAmerican Journal of Respiratory and Critical Care Medicine, 2004